Laparoscopic repair of a ruptured bladder in an adult mare

A bladder rupture suffered by an adult mare during parturition was repaired, using a laparoscopic approach with the mare in dorsal recumbency. During the laparoscopic approach, the bladder was empty, inverted and had a rent on the dorsal apical surface. The bladder was located far caudally within the pelvis. By grasping the left lateral ligament and exerting gentle traction, it proved possible to manoeuvre the bladder more cranially where the rupture could be sutured. The benefits of the laparoscopic approach are reduction in incision size, visualisation of the tear, reachability of the empty bladder and the tear, and reduced reconvalescence time.     

Uroperitoneum attributable to ruptured urachus in a yearling bull.

Ruptured urachus was found to result in uroperitoneum in a yearling Beefmaster bull. The uroperitoneum was initially believed to be attributable to ruptured bladder secondary to urolithiasis; however, catheter decompression of the bladder through an ischiatic urethrotomy did not resolve the uroperitoneum. The persistent urachus was diagnosed and removed through caudal right flank laparotomy with the bull standing. The urachus was attached to the umbilicus, communicated with the lumen of the bladder, and had a mucosal lining. Ruptured urachus is an unusual cause of uroperitoneum, but can cause clinical signs identical to those of ruptured bladder. Persistent urachus is a congenital abnormality in many species, but may be hereditary in Beefmaster cattle. In addition, the bull in this report developed hyperkalemia, which is considered an unusual finding in cattle with uroperitoneum.     

Laparoscopic repair of ruptured urinary bladder in a stallion

A 12-year-old stallion was evaluated because of pollakiuria; endoscopy of the urinary tract during general anesthesia revealed that the urinary bladder was intact. After recovery, the stallion developed clinical and biochemical signs of bladder rupture, which was confirmed by endoscopy. Cystoplasty in adult stallions represents a unique surgical dilemma; the large distance between the incision site and the bladder necessitates the repair be accomplished under maximum tension with minimal exposure. Because traditional surgical approaches through ventral midline or paramedian incisions provide limited access and viewing, laparoscopy was used to provide a definitive diagnosis, good viewing, easy access, tension-free dissection, and a secure repair. Lack of surgical complications and postoperative discomfort, rapid and uncomplicated healing, and patient-client satisfaction make laparoscopic cystoplasty the preferred method for surgical repair of ruptured urinary bladder in adult stallions.     

Nonsurgical management of ruptured urinary bladder in a critically ill foal

A small tear in the urinary bladder of a severely debilitated 4-day-old foal was managed with an indwelling urinary catheter connected to a urine collecting system. Fluid therapy, parenteral nutrition, and antimicrobial agents were used during the initial management of the ruptured bladder. Aseptic technique for catheter care and systemic administration of antimicrobial agents prevented the development of bacterial cystitis. Catheter management required constant monitoring, but the bladder defect was sealed within 5 days. Fungal arthritis caused by Candida tropicalis, immune-mediated anemia, diarrhea, constipation, venous thrombosis, and pneumonia were observed during 43 days of hospitalization. Although the foal died at 3 months of age, serum creatinine concentration and electrolyte values remained within normal limits during the 3-month period.     

Rectal prolapse associated with urinary bladder neoplasia in a cat

A case of feline rectal prolapse which appeared to be secondary to transitional cell carcinoma of the urinary bladder is described. The cat was reported to be incontinent and treatment was declined by the owners. Euthanasia was performed and necropsy revealed an extensive nodular thickening of the entire urinary bladder wall. A diagnosis of urinary bladder transitional cell carcinoma was made on histopathological examination.     

Standing laparoscopic repair of a ruptured urinary bladder in a mature draught horse

Rupture of the urinary bladder, although relatively common in foals, is an infrequent occurrence in adult stallions. Standing laparoscopic repair of a ruptured urinary bladder offers significant advantages over other treatment options, and to date, there are no reports describing this technique in treating adult stallions. This case study details the treatment of a mature draught horse for uroperitoneum secondary to a ruptured urinary bladder. Standing laparoscopic repair of the ruptured bladder was performed. No major post operative complications developed, and the horse has not had any recurrence of problems with the urinary bladder. Successful standing laparoscopic repair in this horse demonstrated the method's viability, which offers superior intraoperative visualisation and access to the bladder, while eliminating the risks of general anaesthesia.     

Retroflexion of the urinary bladder associated with a perineal hernia in a female cat

A case of retroflexion of the urinary bladder into a bilateral perineal hernia in a female domestic shorthaired cat, three weeks postpartum, is reported. The bladder was repositioned and a cystopexy performed. A pelvic ostectomy was also carried out in order to alleviate the narrowing of the pelvic canal caused by an untreated acetabular fracture. Bilateral perineal herniorrhaphy was performed.     

Hemolytic-uremic syndrome in a postpartum mare concurrent with encephalopathy in the neonatal foal.

A postpartum mare and foal were presented for evaluation of fever and lethargy in the mare. The mare was diagnosed with endometritis and initially responded well to treatment. On the second day of hospitalization, the mare developed renal insufficiency characterized by oliguria, azotemia, hemolysis, and thrombocytopenia. Concurrently, the foal developed rapidly progressive central nervous system signs culminating in refractory seizures. Both animals failed to respond to treatment and were euthanized. Thrombotic microangiopathy involving glomeruli was evident on microscopic examination of the mare's kidneys. Microscopic evidence of brain edema was the principal postmortem finding in the foal. No specific etiology was confirmed in either case. Notably, Escherichia coli 0103:H2 was isolated from the mare's uterus and the gastrointestinal tracts of both animals. To the authors' knowledge, this is the first report in which an organism implicated as a cause of hemolytic-uremic syndrome was isolated from an animal with clinical signs and postmortem findings consistent with the disease.     

Repair of urinary bladder rupture through a urethrotomy and urethral sphincterotomy in four postpartum mares

OBJECTIVE: To report the clinical findings, surgical technique, and outcome after repair of urinary bladder rupture through a urethral incision in postpartum mares. STUDY DESIGN: Retrospective study. ANIMALS: Four Thoroughbred broodmares. METHODS: Medical records were reviewed for clinical signs, surgical technique, medical therapy, and outcome. The bladder was everted into the vagina through a urethral incision that included a sphincterotomy. The bladder defect was repaired with absorbable suture material in a single-layer, full thickness, simple, continuous pattern. The urethral incision was closed similarly. RESULTS: Depression, inappetence, signs of shock, dehydration, azotemia, and serum electrolyte abnormalities were consistent findings that increased temporally after bladder rupture. Each bladder defect was repaired successfully, and metabolic derangements were corrected with supportive medical therapy. All mares survived, conceived, and had more foals without further complications CONCLUSION AND CLINICAL RELEVANCE: Bladder rupture associated with parturition in mares can be repaired in a standing position by eversion of the bladder through a urethrotomy and urethral sphincterotomy.     

A non-invasive technique for standing surgical repair of urinary bladder rupture in a post-partum mare: a case report

An 11-year-old mare presented 36 hours after foaling with a ruptured bladder. Uroperitoneum was diagnosed on ultrasound and from the creatinine concentration of the peritoneal fluid. Bladder endoscopy demonstrated tissue necrosis and a rent in the dorsocranial aspect of the bladder. Following stabilisation, including abdominal drainage and lavage, the mare was taken to standing surgery. Under continuous sedation and epidural anaesthesia, and after surgical preparation, a Balfour retractor was placed in the vagina. Using sterile lubricant and moderate force, it was possible to insert a hand into the bladder. The tear was easily palpable on the dorsal portion of the bladder. Two fingers were inserted through the tear and used to provide traction to evert the bladder completely into the vagina where it could grasped with the surgeons other hand to prevent further trauma. A second surgeon could then visualise the entire tear and repaired this using a single layer of size zero PDS suture in a single continuous pattern. As soon as the bladder was repaired, it was replaced via the urethra. The mare did well after surgery and was discharged after 48 hours, apparently normal.This report is the first describing repair of the bladder without an abdominal incision or incision into the urethral sphincter. This greatly reduces the chance of possible complications such as urine pooling after surgery with the previously described standing technique or bladder trauma due to traction with abdominal surgery.     

Primary ovarian adenocarcinoma associated with teratomatous elements in a mare

An ovarian adenocarcinoma with teratomatous elements was removed from a 9-year-old mare. Although no other lesions were detected at ovariectomy, multifocal metastatic masses led to cachexia and euthanasia 2 months later. This case reaffirms the need to exercise caution when removing ovarian masses to prevent seeding of the abdomen. This report includes discussion of the WHO system of classification of ovarian tumors.     

Septic peritonitis in a Percheron mare associated with Clostridium haemolyticum

This report describes an 11‐year‐old Percheron mare that presented with signs of colic and was ultimately diagnosed with bacterial peritonitis of unknown origin. Bacterial culture of a peritoneal fluid sample isolated 2 Clostridial species, one of which was strongly suspected to be Clostridium haemolyticum. The horse was markedly hypoalbuminaemic at presentation, leading to the development of low oncotic pressure and ventral oedema. The mare was administered a low molecular weight/low molar substitution hydroxyethyl starch solution in conjunction with other therapies that resulted in marked improvement of clinical signs. The purpose of this report is to describe the clinical findings associated with equine peritonitis associated with C. haemolyticum, a rarely identified pathogen in the horse. Secondly, this report serves to describe the beneficial effects of tetrastarch administration in a clinical case with severe hypoalbuminaemia and ventral oedema.     

Intra-abdominal hemorrhage associated with a granulosa-thecal cell neoplasm in a mare

A 9-year-old American Saddlebred mare was referred because of abdominal distention and signs of abdominal pain. Copious peritoneal fluid obtained by abdominocentesis appeared to be frank blood. Rectal and ultrasonographic evaluation of the abdomen revealed a large mass at the distal tip of the right uterine horn. The mare was euthanatized and necropsied and the mass was determined to be a granulosa-thecal cell neoplasm. The most common clinical sign of granulosa-thecal cell neoplasm is infertility or abnormal sexual behavior. Hemoperitoneum is infrequently associated with neoplasms in horses.